CMS is automatically reprocessing 2019 hospital claims for certain services provided at grandfathered off-campus provider-based departments (PBD) after a federal judge vacated portions of the 2019 outpatient prospective payment system (OPPS) final rule. However, the agency has filed an appeal...Read More »
The National Association of Healthcare Revenue Integrity Professionals (NAHRI) has extended its deadline for accepting applications for its board and committees. Taking an active role in NAHRI can set you on...Read More »
Medicare made $54.4 million in improper payments to acute care hospitals for post-acute transfers that did not comply with Medicare’s policies, according to a November 1 report from the Office of Inspector General (OIG).Read More »
The American Hospital Association (AHA) and other hospital groups argue that the final rule is unlawful because it exceeds CMS' statutory authority.Read More »
Earning credentials are a career milestone but preparing for the exam is a challenge for even the savviest professional. The Certification in Healthcare Revenue Integrity (CHRI) Practice Exam can help you gain confidence and brush up on your test-taking skills.Read More »
Q: I'm told, although I'm not convinced, that our payment for Keytruda is denied by Anthem when we use Z51.11 (encounter for antineoplastic chemotherapy) first followed by the code for cancer, i.e. C34.12 (malignant neoplasm of upper lobe, left bronchus or lung). I reviewed the coding guidelines...Read More »
Expanded price transparency requirements are set to become reality for hospitals effective January 1, 2021. On November 15, CMS released a final rule that pushed ahead with many of the requirements originally included in the 2020 OPPS proposed rule.Read More »
NAHRI is currently accepting applications for its board and committees. Taking an active role in NAHRI can set you on the path to shape the future of the revenue integrity profession as well as advance your career.
